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Can AICA Type II Loop In The Internal Auditory Canal Cause Lightheadedness?
Question: Hi,
A month back, I noticed that when i smile or keep my mouth in certain angles, the outer corner of my lips quivers and it is noticeable in my cheeks (cheeks twitch/tremble). I met with a Neuro and took a MRI recently.
The impression is this -> Neurovascular contact of the left VII th nerve with the AICA loop in the internal auditory canal (Type II AICA Loop)
My neuro has currently advised me to ignore because the twitches dont happen at rest and is mimimal during certain movements. However, I do experience light headness these days, which occurs almost every day. I also feel tightness and heaviness in my left cheek and middle forehead (like somebody has slapped me)
My questions are-
1. Is my light headedness related to the AICA Type II loop in my IAC? I have had past history of rocking sensation for 2 years from 2012-2014, which miraculously subsided once i got pregnant. I feel pretty much similar to that now. Could this be related?
2. Will this condition worsen when the loop compresses my 7th nerve more that I develop something more serious like Hemifacial Spasm? What should I do to ensure that my current condition doesnt worsen?
A month back, I noticed that when i smile or keep my mouth in certain angles, the outer corner of my lips quivers and it is noticeable in my cheeks (cheeks twitch/tremble). I met with a Neuro and took a MRI recently.
The impression is this -> Neurovascular contact of the left VII th nerve with the AICA loop in the internal auditory canal (Type II AICA Loop)
My neuro has currently advised me to ignore because the twitches dont happen at rest and is mimimal during certain movements. However, I do experience light headness these days, which occurs almost every day. I also feel tightness and heaviness in my left cheek and middle forehead (like somebody has slapped me)
My questions are-
1. Is my light headedness related to the AICA Type II loop in my IAC? I have had past history of rocking sensation for 2 years from 2012-2014, which miraculously subsided once i got pregnant. I feel pretty much similar to that now. Could this be related?
2. Will this condition worsen when the loop compresses my 7th nerve more that I develop something more serious like Hemifacial Spasm? What should I do to ensure that my current condition doesnt worsen?
Brief Answer:
Lightheadedness is not related to AICA loop.
Detailed Answer:
Hi,
Thank you for posting your query.
I am Dr Sudhir Kumar, Neurologist, and would try my best to help you.
I have noted the clinical details, as well as the MRI brain reports.
The finding is often incidentally noted, and is not of concern.
1. Your symptoms of lightheadedness and rocking sensation are not related to the AICA loop.
2. This condition usually does not get worse over time, and hence, there is no concern that you would develop hemifacial spasm or blepharospasm in the future.
I sincerely hope my reply has helped you.
I would be pleased to answer, if you have any follow up queries or if you require any further information.
Best wishes,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX
For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/
Lightheadedness is not related to AICA loop.
Detailed Answer:
Hi,
Thank you for posting your query.
I am Dr Sudhir Kumar, Neurologist, and would try my best to help you.
I have noted the clinical details, as well as the MRI brain reports.
The finding is often incidentally noted, and is not of concern.
1. Your symptoms of lightheadedness and rocking sensation are not related to the AICA loop.
2. This condition usually does not get worse over time, and hence, there is no concern that you would develop hemifacial spasm or blepharospasm in the future.
I sincerely hope my reply has helped you.
I would be pleased to answer, if you have any follow up queries or if you require any further information.
Best wishes,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX
For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much doctor for the reassurance, it gives me a lot of confidence.
One thing I wanted to understand from you is -
1. Is this AICA loop something only few people have or does everybody have AICA loops
2. What is this grading all about? What is the significance of it, if any. Because if i google it, everybody talks about microvascular decompression and all that which seems like this is not a common finding. Pls help!
One thing I wanted to understand from you is -
1. Is this AICA loop something only few people have or does everybody have AICA loops
2. What is this grading all about? What is the significance of it, if any. Because if i google it, everybody talks about microvascular decompression and all that which seems like this is not a common finding. Pls help!
Brief Answer:
Only a few have AICA loops
Detailed Answer:
Thank you for getting back.
1. AICA loop is found in only a few people, and not all.
2. Grading is done to show the extent of AICA loop in the internal auditory canal. It is usually graded from type 1 to type 3. The longest loops are graded type 3.
Decompression means a surgical separation of the nerve from the vascular loop. This is undertaken only if the vascular loop is producing symptoms. (In many cases, the vascular loop is noted on MRI, and it does not produce symptoms. In such cases, surgical microvascular decompression is not needed). The symptoms that respond to microvascular decompression are hearing loss and tinnitus.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Only a few have AICA loops
Detailed Answer:
Thank you for getting back.
1. AICA loop is found in only a few people, and not all.
2. Grading is done to show the extent of AICA loop in the internal auditory canal. It is usually graded from type 1 to type 3. The longest loops are graded type 3.
Decompression means a surgical separation of the nerve from the vascular loop. This is undertaken only if the vascular loop is producing symptoms. (In many cases, the vascular loop is noted on MRI, and it does not produce symptoms. In such cases, surgical microvascular decompression is not needed). The symptoms that respond to microvascular decompression are hearing loss and tinnitus.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for your prompt reply, Doctor.
Few more questions - So, my current condition of having twitches around my outer corner of the left side of the mouth when i stretch the muscle like smiling, yawning, opening the mouth (like somebody is trying to take a look at my tonsils) is related to the neurovascular contact of the 7th nerve with the AICA loop or is this completely unrelated? If that is not the reason for this, what else could be causing this? As I said, I also feel heaviness in my left cheek. What could be causing this issue?
- Will this contact of the loop with my 7th cranial nerve - is there a chance that it could move later in terms of not touching anymore or is this how I was born with? Is this a recent development in the brain or is it something that has always been there, but not caused any issue until now?
Looking fwd to your response.
Few more questions - So, my current condition of having twitches around my outer corner of the left side of the mouth when i stretch the muscle like smiling, yawning, opening the mouth (like somebody is trying to take a look at my tonsils) is related to the neurovascular contact of the 7th nerve with the AICA loop or is this completely unrelated? If that is not the reason for this, what else could be causing this? As I said, I also feel heaviness in my left cheek. What could be causing this issue?
- Will this contact of the loop with my 7th cranial nerve - is there a chance that it could move later in terms of not touching anymore or is this how I was born with? Is this a recent development in the brain or is it something that has always been there, but not caused any issue until now?
Looking fwd to your response.
Brief Answer:
The contact of the vascular loop is not the cause of your symptoms.
Detailed Answer:
Thank you for getting back with more queries.
The contact of the vascular loop with the facial nerve is not the cause of your symptoms. The exact cause is unknown in your case, and that is the case with majority of these cases (we refer to these cases as idiopathic).
The vascular loop is normally seen in several people. Most probably they are born with it, however, it is difficult to say that as MRI brain is not done in most newborn babies.
In future, it may remain like this and may not change or may move away (as happens in some people).
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
The contact of the vascular loop is not the cause of your symptoms.
Detailed Answer:
Thank you for getting back with more queries.
The contact of the vascular loop with the facial nerve is not the cause of your symptoms. The exact cause is unknown in your case, and that is the case with majority of these cases (we refer to these cases as idiopathic).
The vascular loop is normally seen in several people. Most probably they are born with it, however, it is difficult to say that as MRI brain is not done in most newborn babies.
In future, it may remain like this and may not change or may move away (as happens in some people).
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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